Skip to main content

Advertisement

Log in

Classroom Changes in ADHD Symptoms Following Clinic-Based Behavior Therapy

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

This study examined classroom behavioral outcomes for children with Attention-Deficit/Hyperactivity Disorder (ADHD) following their participation in a manualized, 10-week intervention called Family Skills Training for ADHD-Related Symptoms (Family STARS). Family STARS combined behavioral parent training (BPT) and child-focused behavioral activation therapy (CBAT). Participants were children ages 7–10 diagnosed with ADHD-Combined Type. Pre- and post-treatment teacher ratings of ADHD symptoms were compared using a single group, within-subjects research design. Intervention effectiveness was analyzed using paired-samples t-tests. Results indicated statistically significant classroom improvements for externalizing behaviors and attention problems with medium and large main effects (respectively) for the intervention. Possible implications for combining CBAT with BPT for the treatment of ADHD are discussed as well as the relevance of these results for improving the effectiveness and portability of empirically supported interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Abikoff, H. B., Jensen, P. S., Arnold, L. E., Hoza, B., Hechtman, L., Pollack, S., et al. (2002). Observed classroom behavior of children with ADHD: Relationship to gender and comorbidity. Journal of Abnormal Child Psychology, 30, 349–360.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.

  • Antrop, I., Roeyers, H., Oosterlaan, J., & Van Oost, P. (2002). Agreement between parent and teacher ratings of disruptive behavior disorders in children with clinically diagnosed ADHD. Journal of Psychopathology and Behavioral Assessment, 24, 67–73.

    Article  Google Scholar 

  • Barkley, R. A. (1997a). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65–94.

    Article  PubMed  CAS  Google Scholar 

  • Barkley, R. A. (1997b). Defiant children: A clinician’s manual for assessment and parent training (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Barkley, R. A., & Murphy, K. R. (2006). Attention-deficit hyperactivity disorder: A clinical workbook (3rd ed.). New York: Guilford Press.

  • Biederman, J., Faraone, S. V., Monuteaux, M. C., & Grossbard, J. R. (2004). How informative are parent reports of attention-deficit/hyperactivity disorder symptoms for assessing outcome in clinical trials of long-acting treatments? A pooled analysis of parents’ and teachers’ reports. Pediatrics, 113, 1667–1671.

    Article  PubMed  Google Scholar 

  • Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7–18.

    Article  PubMed  CAS  Google Scholar 

  • Chi, T. C., & Hinshaw, S. P. (2002). Mother–child relationships of children with ADHD: The role of maternal depressive symptoms and depression-related distortions. Journal of Abnormal Child Psychology, 30, 387–400.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Coles, E. K., Pelham, W. E., Gnagy, E. M., Burrows-MacLean, L., Fabiano, G. A., Chacko, A., et al. (2005). A controlled evaluation of behavioral treatment with children with ADHD attending a summer treatment program. Journal of Emotional and Behavioral Disorders, 13, 99–112.

    Article  Google Scholar 

  • Counts, C. A., Nigg, J. T., Stawicki, J. A., Rappley, M. D., & Von Eye, A. (2005). Family adversity in DSM-IV ADHD combined and inattentive subtypes and associated disruptive behavior problems. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 690–698.

    Article  PubMed  Google Scholar 

  • Cunningham, C. E. (2005). COPE: Large-group, community-based, family-centered parent training. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd ed., pp. 480–498). New York: Guilford.

    Google Scholar 

  • Cunningham, C. E. (2007). A family-centered approach to planning and measuring the outcome of interventions for children with attention-deficit/hyperactivity disorder. Journal of Pediatric Psychology, 32, 676–694.

    Article  PubMed  Google Scholar 

  • Curtis, D. F. (2010). ADHD symptom severity following participation in a pilot, 10-week, manualized, family-based behavioral intervention. Child and Family Behavior Therapy, 32, 231–241.

    Article  Google Scholar 

  • Dadds, M. R., Sanders, M. R., & James, J. E. (1987). The generalization of treatment effects in parent training with multidistressed parents. Behavioural Psychotherapy, 15, 289–313.

    Article  Google Scholar 

  • Diamond, G., & Josephson, A. (2005). Family-based treatment research: A 10-year update. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 872–887.

    Article  PubMed  Google Scholar 

  • DuPaul, G., & Power, T. J. (2008). Improving school outcomes for students with ADHD: Using the right strategies in the context of the right relationships. Journal of Attention Disorders, 11, 519–521.

    Article  PubMed  Google Scholar 

  • DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998a). ADHD Rating Scale—IV: Checklists, norms, and clinical interpretation. New York: Guilford Press.

    Google Scholar 

  • DuPaul, G. J., Power, T. J., McGoey, K. E., Ikeda, M. J., & Anastopoulos, A. D. (1998b). Reliability and validity of parent and teacher ratings of attention-deficit/hyperactivity disorder symptoms. Journal of Psychoeducational Assessment, 16, 55–68.

    Article  Google Scholar 

  • Epstein, J. N., Langberg, J. M., Lichtenstein, P. K., Altaye, M., Brinkman, W. B., House, K., et al. (2010). Attention-deficit/hyperactivity disorder outcomes for children treated in community-based pediatric settings. Archives of Pediatrics and Adolescent Medicine, 164, 160–165.

    Article  PubMed  Google Scholar 

  • Fabiano, G., Pelham, W. E., Coles, R., Gnagy, E., Chronis, A., & O’Connor, B. (2009). A meta-analysis of behavioral treatments for attention deficit/hyperactivity disorder. Clinical Psychology Review, 29, 129–140.

    Article  PubMed  Google Scholar 

  • Glaser, B., Kronsnoble, K., & Forkner, C. (1997). Parents and teachers as raters of children’s problem behaviors. Child and Family Behavior Therapy, 19, 1–13.

    Article  Google Scholar 

  • Gomez, R. (2007). Australian parent and teacher ratings of the DSM-IV ADHD symptoms: Differential symptom functioning and parent–teacher agreement and differences. Journal of Attention Disorders, 11, 17–27.

    Article  PubMed  Google Scholar 

  • Hartman, C. A., Rhee, S. H., Willcutt, E. G., & Pennington, B. F. (2007). Modeling rater disagreement for ADHD: Are parents or teachers biased? Journal of Abnormal Child Psychology, 35, 536–542.

    Article  PubMed  Google Scholar 

  • Kaplan, B. J., Crawford, S. G., Dewey, D. M., & Fisher, G. C. (2000). The IQs of children with ADHD are normally distributed. Journal of Learning Disabilities, 33, 425–432.

    Article  PubMed  CAS  Google Scholar 

  • Kraemer, H. K. (1992). Reporting the size of effects in research studies to facilitate assessment of practical or clinical significance. Psychoneuroendocrinology, 17, 527–536.

    Article  PubMed  CAS  Google Scholar 

  • McGoey, K. E., Eckert, T. L., & DuPaul, G. J. (2002). Early intervention for preschool-age children with ADHD: A literature review. Journal of Emotional and Behavioral Disorders, 10, 14.

    Article  Google Scholar 

  • McMahon, R. J., & Forehand, R. L. (2005). Helping the non-compliant child: Family-based treatment for oppositional behavior (2nd ed.). New York: Guilford.

    Google Scholar 

  • MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56, 1073–1086.

    Article  Google Scholar 

  • Murray, D., Kollins, S., Hardy, K., Abikoff, H., Swanson, J., Cunningham, C., et al. (2007). Parent versus teacher ratings of attention-deficit/hyperactivity disorder symptoms in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS). Journal of Child and Adolescent Psychopharmacology, 17, 605–619.

    Article  PubMed  Google Scholar 

  • National Institutes of Mental Health [NIMH]. (2008). Attention deficit hyperactivity disorder (ADHD). U.S. Department of Health and Human Services, National Institutes of Health (NIH Publication No. 08-3572). Washington, DC: Author.

  • Ollendick, T. H. (2005). Evidence-based parent and family interventions in school psychology: A commentary. School Psychology Quarterly, 20, 512–517.

    Article  Google Scholar 

  • Pelham, W., & Fabiano, G. (2001). Treatment of attention-deficit/hyperactivity disorder: The impact of comorbidity. Journal of Clinical Psychology and Psychotherapy, 8, 315–329.

    Article  Google Scholar 

  • Pelham, W., & Fabiano, G. (2008). Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 37, 184–214.

    PubMed  Google Scholar 

  • Podolski, C. L., & Nigg, J. T. (2001). Parent stress and coping in relation to child ADHD severity and associated child disruptive behavior problems. Journal of Clinical Child Psychology, 30, 503–513.

    Article  PubMed  CAS  Google Scholar 

  • Reid, J. B., Kavanagh, K., & Baldwin, D. V. (1987). Abusive parents’ perception of child problem behaviors: An example of parental bias. Journal of Abnormal Child Psychology, 15, 457–466.

    Article  PubMed  CAS  Google Scholar 

  • Reynolds, C., & Kamphaus, R. (2004). The Behavior Assessment System for Children-2 (BASC-2) Manual. Circle Pines, MN: AGS\Publishing.

  • Sanders, M. R. (1999). The Triple P-Positive parenting program: Towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clinical Child and Family Psychology Review, 2, 71–90.

    Article  PubMed  CAS  Google Scholar 

  • Treacy, L., Tripp, G., & Baird, A. (2004). Parent stress management training for attention-deficit/hyperactivity disorder. Behavior Therapy, 36, 223–233.

    Article  Google Scholar 

  • Valdez, C., Carlson, C., & Zanger, D. (2005). Evidence-based parent training and family interventions for school behavior change. School Psychology Quarterly, 20, 403–433.

    Article  Google Scholar 

Download references

Acknowledgments

This project was supported by internal funding for patient care by the Psychology Service at Texas Children’s Hospital.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David F. Curtis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Curtis, D.F., Chapman, S., Dempsey, J. et al. Classroom Changes in ADHD Symptoms Following Clinic-Based Behavior Therapy. J Clin Psychol Med Settings 20, 114–122 (2013). https://doi.org/10.1007/s10880-012-9307-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10880-012-9307-2

Keywords

Navigation